Provider Demographics
NPI:1760008056
Name:LI, JIAYING (RDN)
Entity Type:Individual
Prefix:MS
First Name:JIAYING
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4592 COLONIAL DR APT 1
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-3914
Mailing Address - Country:US
Mailing Address - Phone:734-926-7270
Mailing Address - Fax:
Practice Address - Street 1:3200 STATE ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-3475
Practice Address - Country:US
Practice Address - Phone:734-926-7270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86170113133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered